Clinical sensitivity and specificity of fourth-generation RDTs for acute HIV-1 were collated from field evaluation studies in adults
Introduction: Fourth-generation HIV-1 rapid diagnostic tests (RDTs) detect HIV-1 p24 antigen to screen for acute HIV-1. However, diagnostic accuracy during clinical use may be suboptimal.
Methods: Clinical sensitivity and specificity of fourth-generation RDTs for acute HIV-1 were collated from field evaluation studies in adults identified by a systematic literature search.
Results: 4 studies with 17 381 participants from Australia, Swaziland, the United Kingdom and Malawi were identified. All reported 0% sensitivity of the HIV-1 p24 component for acute HIV-1 diagnosis; 26 acute infections were missed. Specificity ranged from 98.3 to 99.9%.
Conclusion: Fourth-generation RDTs are currently unsuitable for the detection of acute HIV-1.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Joseph M. Lewis, Peter Macpherson, Emily R. Adams, Eleanore Ochodo, Anita Sands, Miriam Taegtmeyer. Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review. AIDS. 2015 November 28; 29(18): 2465–2471. doi: 10.1097/QAD.0000000000000855